HomeMy WebLinkAboutSWG2022-00496 - SWG As-Built - 8/22/2024 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 2022-00496 Assessor Parcel# 319041190020
Applicant Name Hess Daniel & Sara Subdivision (Name/Div/Block/Lot)
Applicant Address 18623 Elderberry st sw Lot 2
City, state,zip Rochester WA 98579 Installer Name EnviroTech Septic
Site Address 150 Sister Meadows Ln SE Designer Name Jim Hunter
INSTALLATION CHECKLIST
0 Full System Installation ElSeptic Tank Only [IDralnfleld Only [IRepair
System Type shallow trenches. Pl.S Pretreatment Type RFC 1(
>5 ft.from foundation? -------------------------- - ❑NIA ®YEa ❑ O
>50 ft.from wells? ----------------------------- ❑ ® ❑
Z >50 ft.from surface water? ------------------------ ❑ ® ❑
FCleanout between building and tank? ------------------ - ❑ ® ❑
0 Tank baffles present? --------------------------- ❑ ® ❑
I— 24"access deers over each compartment?-------------- -- ❑ ❑
rW Effluent fitter installed?------------------------ ❑ 0 ❑
Septic tank size 1200 gal Manufacturer HB Precast
0 D-box water level and speed levelers used? --------------- NIA ❑YES NO
OLL Manifold/D-box accessible from surface?----------------- ❑ ® ❑
oZ Check valves Installed? ------------------------- - ® ❑ ❑
Transport Line Size 2inch Schedule/Gass schedule 40
Bedrooms installed(check one) ❑ 2 ❑3 Its 4 ❑5 ❑6
>10ft.from foundation?------------------------- - ❑ NIA DYES El No
0 >1001t.fromwells?----------------------------- ❑ 0 ❑
W >100 ft.from surface wider?------------------------ ❑ 0 El
LL >101t.from potablewater lines?---------------------- ❑ 0 ❑
aZ >5 ft.from property lines and easements?---------------- ❑ W ❑
d >30 ft.from downgradient curtain/foundation drains?---------- ❑ 0 ❑
0 Drainfield level and observation ports present--- - ---------- ❑ 0 ❑
t17 Graveless chambers or ❑ Clean gravel used? (check one) j o
Proper cover installed over dreinfleld?----------------- - ❑ ® ❑
Pump tank setbacks consistent with septic tank?------------- ❑ NA ® vas ❑ Np
2
Pump tank size 1200 gat Manufacturer HB Precast
Q 24"access riser(s)and accessible from surface?-------------
❑ ® ❑ I �
r r
y Alarm or Control Panel Installed? -------------------- ❑ ® ❑ r
2 Control Panel equipped with Timer/ETM/Counter-----------
Pump installed in ❑ Bucket or ® On Block or ❑ Other
f Pump MakelModel Zoeller N-152 [0Floats or ❑Transducer
a Tank dmw down 3.25in in/min Pump capacity 60 gpm Squirt Height 24in ft
Pump on time 1min Pump off time 4hr Daily flow set at 80 gpm
.W 1.14
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
❑ Drainheld&
manifold orientation
&layout
❑ Tonobilad
dimensbns and
critical distances
within layout
❑ Seplicipump tank
_ placement I, n
❑ Location of
buildings
❑ Observation ports& V
cleanaut locations
❑ Location of wells,
surface water.it
roads
❑ undisturbed native
sell bebaean
trenches
❑ Nodh Anew
It the designer or installer feel the need for additional informailon/comnrents,it may be attached.
Record drawing may also be on a separate page attached. No.Pages Adeched
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
I certify that I Installed the system in accordance with I certify that the system has been Installed/n accor-
the septic design stamped'APPROVED"by Mason dance With the septic design stamped'APPROVED"by
County Public Health and that any deviations shown Mason County Public Health and that any deviations
here have been cleared/approved by both the designer shown here have been cleared/approved by both
and Mason County Public Health and meet all State myself and Mason County Public Health and meet all
and Mason County Codes. State and Mason County Codes
I further certiy that all information contained on this I further certify that all Information contained on this
form and attached Record Drawing is accurate. form and attached Rom wing Is a
Signet reo/Installer Date
r
Printed Name of Slgnee
MASON COUNTY PUBLIC HEALTH .<• ��ar
4 SIW213
The undersigned approves this Installation Report and r*a
N
Record Drawing on behalf of Mason County Public LICEN A r&efr[n _
NSED DESK.Nra
Health: EXPIMS: 03IZ2/-+ "
Signature ofEnvlronnrental 14eafth Specialist Dale (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SRE
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